Six.
Sleep was easier and yesterday’s nose has finally turned its tap off. I still feel full of a headcold but I think it’s getting better from here. Shower, breakfast, ward 01. I join the round with Dave, Philippa and Rachel. It passes bay to bay but is so fast and with so many students we can barely understand what is happening.
Once it finishes we decide to examine a young girl in the high dependency unit. She is about six, wide awake, wears a Pokémon stick-on tattoo on her right arm and giggles constantly. I listen in and can hear a systolic murmur loudest in the mitral area. It is difficult to tell whether it is throughout all of systole or just specific parts because she is tachycardic, and as children’s hearts beat faster than adult’s when they’re healthy, this makes the job really tough. She is due to have an ECHO. The chart indicates she is febrile so we wonder about rheumatic fever.
Dave has only been on paediatrics for the past six weeks whilst the three of us have all spent time on the general medicine ward, so he is keen to see it. We take him along and I wave at Eva who is still here after all this time. There are two new German students, along with the two Australian boys. I speak with the senior registrar and ask about any interesting cardiovascular patients we could examine. Although the staff and I didn’t exactly chat those weeks ago, we are both pleased to see each other. I am directed to bed 25. Dave speaks Sinhala and gains consent for me. The patient is an elderly man with a displaced apex beat, quiet diastolic murmur, bilateral crepitations and peripheral pitting oedema. His pulse is regular and I find nothing else to note. Dave examines him and we compare our findings. I think he’s in heart failure and I think it’s because of mitral valve disease. Then we go and examine a patient with hepatomegaly among other signs of chronic liver disease. Dave wants to see more patients but I don’t, so I head back to ward 01 whilst he continues making the most of his half-morning on general medicine. Then we have a class and I head back to the apartment.
The Internet seems to get slower by the minute, which with little else to do besides watch the rain fall, is making the time drag a bit. I hope I will be able to check-in online on Sunday night for Monday’s flight. I am looking forward to my fish and chips welcome home.
Ramblings Of A Med Student 